By Kendall McGee | January 1, 2021 at 12:40 PM EST – Updated January 1 at 7:21 PM
WILMINGTON, N.C. (WECT) – The new year is bringing the start of new laws.
Beginning Friday, hospitals around the country must be in compliance with a Centers for Medicare and Medicaid Services rule that mandates patients have access to clear, accessible pricing information online about the services they provide.
Hospitals have to have both a machine-readable file for all their charges and a consumer-friendly display of at least 300 stoppable services. Those services include common things like X-rays, doctor visits, lab tests, and bundled services like having a baby.
That dashboard must have plain language descriptions and show discounted cash prices, and the charges negotiated with different insurance companies.
The whole idea is for people to know what they’re getting into long before they get a medical bill and allow them to pick the hospital that works best for them.
Stephen Hovan, the vice president of revenue at New Hanover Regional Medical Center, says they didn’t have to completely reinvent the wheel to come into compliance but it was a lot of work getting the interface up and compiling all of the pricing information.
“At New Hanover Regional Medical Center, we’ve always had the availability to provide estimates to our patients and the community but it was a process where a phone call had to be made and then we would get back to them with the estimate,” said Hovan.
Over at Novant Health, administrators have made financial navigators available for their patients for some time now, but their new dashboard simply allows anyone to do the price research without utilizing a hospital employee.
Both NHRMC and Novant Health’s price estimator tools were up by Friday. The dashboards look pretty similar between the two hospitals. You can search for the service you’re researching or browse procedures by categories. From there, you can key in your insurance information to see what you’d pay for the service or see how much it would cost without insurance if you paid in cash.
It’s a great way to shop around, but experts caution it shouldn’t be the only thing you consider.
“There’s a lot of things, a lot of variables that should go on the decision when you’re looking to obtain a service. Pricing is one of them, but it does give them the opportunity to not be surprised and to fully understand the services,” said Hovan.
Melonie O’Connell, director of pricing strategy at Novant Health, says the journey to price transparency has been a difficult one the industry has been working on for years. Healthcare is complex and deeply personal. Blanket estimates are difficult to formulate because it’s hard to guess with certainty the exact services a patient will need before they walk in the door.
“It’s taken us decades to get to this place. Our industry is so complicated, so no one solution is going to be a perfect solution, but this is a great step forward,” said O’Connell.
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